92550

Pituitary Apoplexy

Clinical features - depends on the extent and direction of tumor spread and on the extent of necrotic and hemorrhagic mass:

>    sudden headache ;

>    meningismus (accompanied sometimes by fever) - blood and

necrotic debris penetration to the subarachnoid space;

>    vision field defects - suptasellar expansion;

>    oftalmoplegia - oculomotor palsy - compression of nerves

running in cavernous sinus ;

>    consciousness impairment;

>    acute multihormonal pituitary failure (seldom reversible) -

anterior lobe destruction:

-    GH deficiency - 88% of cases,

-    gonadotropin deficiency - 85%,

-    secondary adrenal insufficiency - 66%,

-    secondary hypotyreosis - 44%,

-    diabetes insipidus - rarely (independent pituitary posterior lobe blood supply);